Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
29712
Service:
DTV
Call Sign:
WCWJ
Channel:
20 (UHF)
File Number:
0000027958
FRN:
0002161107
Date Submitted:
05/10/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GRAHAM MEDIA GROUP, FLORIDA. INC.

Doing Business As: GRAHAM MEDIA GROUP, FLORIDA. INC.

James Lowery

4 BROADCAST PLACE

JACKSONVILLE, FL 32207

United States

+1 (904) 393-9871 jlowery@wjxt.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

William T Godfrey , Jr. .

Consulting Engineers

Kessler and Gehman Associates, Inc.

William T. Godfrey, Jr.

Kessler and Gehman Associates, Inc.

507-D NW 60th Street

Gainesville, FL 32607

United States

+1 (352) 332-3157 jeff@kesslerandgehman.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan The WCWJ tower must be replaced due to the repack. Instead of building a new tower, it will be dismantled & WCWJ will collocate with WJXT. An interim antenna, transmitter & line are required to operate at alternate site during dismantle of WCWJ tower.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Auxiliary
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Diamond
Year 2005
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.8 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model TMU9
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.8 kW
Justification for New Transmitter The manufacturer of the existing transmitter advises that the transmitter cannot be re-tuned to the assigned channel. See attachment.

Auxiliary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service Yes
Description Disconnect existing transmitter and connect new transmitter after installation
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional Interior RF System

Interior RF System Existing Transmitter to Interim Transmission line.

Standby Exciter and Switch

Standby Exciter with Automatic Change Over Switch.

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Sigma CD3140P2CF
Year 2008
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 34.0 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9EVO-40
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 61.0 kW
Justification for New Transmitter ERP: 1000 kW (1st Priority Station) RMS Gain: 18.9 Azimuth Gain: 1.39 TX Line Loss: 0.812 Mask Filter Loss: 0.931 Combiner Loss: 0.933 H-pol Only TPO: 54.0 kW (THU9EVO-36) 1 Step Up: THU9EVO-40 Upgrade: THU9EVO-48

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 500.0 feet
Other Electrical Service Yes
Description Other electrical services required since WCWJ is moving to the WJXT site and will have to be interfaces with the electrical in the WJXT transmitter building.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Standby Exciter and Switch

Standby Exciter with Automatic Change Over Switch.

Switch

Switch to Combiner Interconnect 8-3/16" 75 ohm.

8-Pole Mask Filter

WCWJ-D20 is located less than 1 km from WJAX-D19 (1st adjacent stations).

50 kW Reject Load

Outside heat exchanger kit: $4,812.50. See Rohde & Schwarz quote.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model THU9EVO-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31.0 kW
Justification for New Transmitter A new transmitter for an interim facility at an alternate site is necessary to keep station on the air while the WCWJ tower is being dismantled and for the duration of the assigned phase. H-pol only TPO: 30.4 kW Required TX: THU9EVO-20

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 500 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 500.0 feet
Other Electrical Service Yes
Description Other electrical services will be required for transmitter building at the alternate site for the interim facility to operate while the tower is being dismantled and through the assigned phase. See lease, bldg & elec quotes.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 450.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transmitter Interconnect

TX output to container in antenna interconnect kit 6-50: $9,600. See Rohde & Schwarz quote.

Additional RF Components

Required to split cabinets in order to meet spacing requirements in transmitter building.

50 kW Reject Load

Outside heat exchanger kit: $10,112.50. See Rohde & Schwarz quote.

Split Configuration

Transmitter split configuration kit to provide required space in in interim container. Cost is $3,950.00. See Rohde & Schwarz quote.

Cooling Pumps Stacking Kit

Required to meet spacing requirements in transmitter building.

Back-up Generator

A temporary generator is required at the interim site while the WCWJ tower is being dismantled.

Required Extra Glycose

Extra glycose and hose accessories kit - 30 meters.

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 863.0 kW
Manufacturer
Model TFU-28GTH-R 6T170
Year 2008

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Top
Polarization Elliptical
Type Broadband Slot
Number of Stations Supported 2
Number of Panels/Bays 24
Lower Limit 497.00 MHz
Upper Limit 509.00 MHz
Design power capacity in use 60.0 %
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-24GTH/VP-R TC O6SP
Year 2018
Justification for New Antenna The existing main antenna is a single channel slotted coaxial which cannot accommodate the assigned channel. The antenna is an upgrade; however, it will result in an overall system savings for the FCC since it will be shared with WJXT.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 2
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
18
20

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna adapter

ANTENNA WEDDING CAKE MOUNTING ADAPTER.

Shipping

Shipping Cost: $9,800

Extension Pole

MOUNTING POLE FOR TOP MOUNTING ANTENNA IN ORDER TO MAINTAIN FAA HEIGHT.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 863.0 kW
Manufacturer
Model TFU-25ETT-R O6T170
Year 2018
Justification for New Antenna An interim antenna is necessary to keep station on the air at an alternate site while the WCWJ tower is being dismantled and while the primary antenna is built-out and throughout duration of assigned phase.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Shipping

Shipping Cost: $9,800

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? Yes

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1005 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1155 feet per run
Justification for New Transmission Line The power rating for 7-3/16" line is not capable of handling the power required for WJXT and WCWJ shared operation. The line is considered an upgrade; however, it will result in an overall system savings since WCWJ and WJXT stations will share the costs.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Shipping

Shipping Cost: $9,800

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 1100 feet per run
Justification for New Transmission Line Interim transmission line is necessary in order to keep WCWJ on the air during primary antenna replacement and for the duration of the assigned phase. This will be at an alternate site since the tower has to be dismantled.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Shipping

Shipping Cost: $5,400

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Auxiliary Tower

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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Auxiliary (Backup)
Description of Use Interim Tower (InSite)
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1016457
Coordinates (NAD83) Latitude (NAD83) 30° 16' 36.0" N-
Longitude (NAD83) 081° 33' 57.0" W-
Overall Structure Height 1001.63 feet
Support Structure Height 950.78 feet
Ground Elevation Above Mean Sea Level (AMSL) 25.92 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner IWG Towers Assets II, LLC
Date Constructed 07/01/1988


Auxiliary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Auxiliary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Auxiliary Tower

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Other Tower Expenses Not Listed

Name Description

Interim Tower Lease

Monthly lease expenses at alternate site (InSite Tower) to support the top-mount interim antenna, TX line and STL for up to 21 months (see attached quote).

Remove Interim Equipment

Interim tower must be rigged a second time after assigned phase is complete to have the interim antenna, interim line, STL dish and waveguide removed from tower and disposed. Old pre-auction top-mount antenna reinstalled for FAA height.

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? Terrain Constrained
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1025608
Coordinates (NAD83) Latitude (NAD83) 30° 16' 37.0" N-
Longitude (NAD83) 081° 33' 46.0" W-
Overall Structure Height 1013.77 feet
Support Structure Height 944.87 feet
Ground Elevation Above Mean Sea Level (AMSL) 32.81 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Graham Media Group, Florida, Inc.
Date Constructed 11/15/1967


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Terrain constrained
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Foundation Expansion

In order to support the loading for WCWJ to collocate with WJXT on the WJXT tower, the guy wire anchor foundations must be reinforced (expanded).

Helicopter Site Staging Requirement

Erickson Incorporated requires a 200 x 200 ft staging area for the helicopter lift. See attached quote to clear the site.

Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 945.00 feet
Justification for New Tower A recent structural analysis indicates that the tower fails when changes are made that invoke EIA-222-G, such as required for this repack. The analysis states that tower cannot be upgraded to comply with the standards (see attached structural analysis).

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Other
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Mapping

Tower mapping cost shared with WJXT related to WCWJ moving to the WJXT tower

Helicopter Site Staging Requirement

See attached quotes. Erickson Inc. requires a 200 x 200 ft clearing for lifts and the only way to achieve this is to have the area clear-cut and also requires a Strong Plank Steel Mat.

Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 945.00 feet
Justification for New Tower A recent structural analysis indicates that the tower fails when changes are made that invoke EIA-222-G, such as required for this repack. The analysis states that tower cannot be upgraded to comply with the standards (see attached structural analysis).

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Other
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Mapping

Tower mapping cost shared with WJXT related to WCWJ moving to the WJXT tower

Helicopter Site Staging Requirement

See attached quotes. Erickson Inc. requires a 200 x 200 ft clearing for lifts and the only way to achieve this is to have the area clear-cut and also requires a Strong Plank Steel Mat.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 1500
Explanation It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 45
Justification It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Osborn Engineering Examination of Interim Site

Professional Services - review existing drawings, design interim transmitter building, prepare conceptual site plan layout, prepare construction documents, provide construction administration services (shared cost with WJXT).

Topographic Survey

Required for new interim transmitter building container (shared cost with WJXT).

Intermod Study at Interim Site

Tower owner requires an intermod study (see attached quote from InSite Towers, LLC)

Osborn Engineering Main Transmitter Facility

Professional Services - main transmitter facility site assessment consisting of on-site laser scanning of both the interior and exterior of the WJXT main transmitter facility (shared costs with WJXT).

Environmental Impact Study

Study conducted due to presence of visible mold in existing interim building. Building determined to be uninhabitable (shared cost with WJXT).

Geotechnical Report

Required for new interim transmitter building container (shared cost with WJXT).

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

STL System

Microwave dish required for interim studio to transmitter link (STL) to be operated up to 21 months. Receiver, waveguide, licensing, etc. required for interim STL. See attached STL quotes.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $4,219,368.50 $3,508,033.54 N/A $0.00 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Interim Transmitter THU9EVO-20 $1,728,256.00 $1,595,356.03 $0.00
Required Extra Glycose $12,000.00 $12,000.00 See Rohde & Schwarz quote for WCWJ interim transmitter. N/A N/A
Back-up Generator $132,500.00 $132,500.00 Back-up generator to be shared at interim site with WCWJ and WJXT. Cost of back-up generator is $265,00; however, shared cost is $132,500 (see attached back-up generator quote from Olympian Generators) N/A N/A
Cooling Pumps Stacking Kit $2,500.00 $2,500.00 Required to meet space requirements in interim transmitter container (building). See Rohde & Schwarz quotes for WCWJ interim transmitter. N/A N/A
Split Configuration $3,950.00 $3,950.00 See attached Rohde & Schwarz quote N/A N/A
50 kW Reject Load $10,112.50 $10,112.50 See attached Rohde & Schwarz quote N/A N/A
Additional RF Components $17,550.00 $17,550.00 RF Components for 2+2 cabinets to meet space requirements in interim transmitter container (building). See Rohde & Schwarz quotes for WCWJ interim transmitter. N/A N/A
Other -- Building Addition Size: 450.0 $254,643.50 $254,643.50 Attached letter from InSite Tower (interim tower) states that new building must be provided. Attached quotes from Osborn Engineering & Advantage Structures for a new 450 sq ft building is $509,287 ($444,940 + $64,347). Shared costs equates to $254,643.50. N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $830,000.03 See attached Rohde & Schwarz quote. See justification box in transmitter section for TPO calculations and transmitter selection justification. N/A N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 500 KVA $48,400.00 $46,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $26,000.00 $24,500.00 N/A N/A N/A
Other Electrical Service: Other electrical services will be required for transmitter building at the alternate site for the interim facility to operate while the tower is being dismantled and through the assigned phase. See lease, bldg & elec quotes. $25,000.00 $25,000.00 Jacksonville Electric Authority (JEA) services must be retained in order to modify on-site transformer to provide required service to new interim building (container). N/A N/A
10 Ton system $38,900.00 $37,000.00 N/A N/A N/A
UHF inside RF system including switching $147,500.00 $140,000.00 N/A N/A N/A
Transmitter Interconnect $9,600.00 $9,600.00 See attached Rohde & Schwarz quote N/A N/A
Primary Transmitter THU9EVO-40 $2,189,912.50 $1,663,212.50 $0.00
50 kW Reject Load $4,812.50 $4,812.50 Outside heat exchanger kit: $4,812.50. See Rohde & Schwarz quote. N/A N/A
8-Pole Mask Filter $177,200.00 $177,200.00 8-pol mask filter required due to 1st-adjacent station issue. See attached Rohde & Schwarz quote. N/A N/A
Switch $30,000.00 $30,000.00 N/A N/A N/A
Standby Exciter and Switch $25,000.00 $25,000.00 N/A N/A N/A
10 Ton system $38,900.00 $37,000.00 N/A N/A N/A
Other Electrical Service: Other electrical services required since WCWJ is moving to the WJXT site and will have to be interfaces with the electrical in the WJXT transmitter building. $25,000.00 $25,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $26,000.00 $24,500.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $20,000.00 See attached Rohde & Schwarz quote. N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,283,400.00 See attached Rohde & Schwarz quote. See justification box in transmitter section for TPO calculations and transmitter selection justification. N/A N/A
Auxiliary Transmitter TMU9 $301,200.00 $249,465.01 $0.00
Standby Exciter and Switch $25,000.00 $25,000.00 N/A N/A N/A
Other Electrical Service: Disconnect existing transmitter and connect new transmitter after installation $5,000.00 $5,000.00 N/A N/A N/A
Additional Interior RF System $140,000.00 $140,000.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $74,565.01 See attached Rohde & Schwarz quote. N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $4,900.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $652,707.50 $540,989.50 N/A $95,450.40 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Interim Antenna TFU-25ETT-R O6T170 $275,830.00 $221,912.00 $95,450.40
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,984.00 See attached Dielectric Quote. $4,942.80 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $2,880.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $194,728.00 See attached Dielectric Quote. $87,627.60 N/A
Shipping $9,800.00 $9,800.00 N/A N/A N/A
Primary Antenna TFU-24GTH/VP-R TC O6SP $376,877.50 $319,077.50 $0.00
Shipping $4,900.00 $4,900.00 Cost: $9,800; however, it is shared cost with WJXT therefore, cost for WCWJ is $4,900. See attached Dielectric Quote. N/A N/A
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $8,880.00 Cost: $17,760; however, it is shared cost with WJXT, therefore, cost for WCWJ is $8,880. See attached Dielectric Quote. N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $40,000.00 Shared cost with WJXT N/A N/A
UHF - High Power Top Mount Two Station antenna elliptically or circularly polarized $175,046.50 $175,046.50 Cost: $350,093; however, it is shared cost with WJXT, therefore, cost for WCWJ is $175,046.50. See attached Dielectric Quote. N/A N/A
Extension Pole $76,315.00 $76,315.00 Cost: $152,630; however, it is shared cost with WJXT, therefore, cost for WCWJ is $76,315. See attached Dielectric Quote. N/A N/A
Antenna adapter $10,736.00 $10,736.00 Cost: $21,472; however, it is shared cost with WJXT, therefore, cost for WCWJ is $10,736. See attached Dielectric Quote. N/A N/A
Sweep test of existing antenna $6,730.00 $3,200.00 Shared cost with WJXT N/A N/A

Components

Actual Information Description File Name
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Inv MAN00266 WCWJ Interim elbow complex 45% down payment UL20180503jgv1
Amount:
$4,942.80
Sweep test of existing antenna

Component Description:
Inv MAN00266 WCWJ Interim sweep test 45% down payment UL20180503jgv1
Amount:
$2,880.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Inv MAN00266 WCWJ Interim TX antenna 45% down payment UL20180503jgv1
Amount:
$87,627.60
Shipping Information not provided.
Shipping Information not provided.
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
UHF - High Power Top Mount Two Station antenna elliptically or circularly polarized Information not provided.
Extension Pole Information not provided.
Antenna adapter Information not provided.
Sweep test of existing antenna Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $693,345.00 $318,052.70 N/A $72,951.98 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Interim Transmission Line $227,600.00 $167,515.50 $72,951.98
Rigid Transmission Line - copper, 6 1/8" $222,200.00 $162,115.50 See Dielectric quote for WCWJ interim facility. $72,951.98 N/A
Shipping $5,400.00 $5,400.00 N/A N/A N/A
Primary Transmission Line $465,745.00 $150,537.20 $0.00
Rigid Transmission Line - copper, 8 3/16" broadband $460,845.00 $145,637.20 Cost: $291,274.40; however, it is shared cost with WJXT, therefore, cost for WCWJ is $145,637.20. See attached Dielectric Quote. N/A N/A
Shipping $4,900.00 $4,900.00 Shipping Cost is $9,800; however, it is a shared expense with WJXT; therefore, WCWJ shipping cost is N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
Inv MAN00266 WCWJ Interim line 45% down payment UL20180503jgv1
Amount:
$72,951.98
Shipping Information not provided.
Rigid Transmission Line - copper, 8 3/16" broadband Information not provided.
Shipping Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $3,105,470.00 $2,478,141.00 N/A $7,218.75 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Primary Tower TOWER $1,259,128.00 $1,209,176.00 $5,218.75
Helicopter Site Staging Requirement $75,000.00 $75,000.00 Clearing required in preparation to dismantlement of the WCWJ tower (instead of building a new tower). N/A N/A
Tower Mapping $25,000.00 $25,000.00 N/A $5,218.75 N/A
New tower $0.00 $0.00 Cost of new replacement tower for WCWJ is $2,586,115.00 (see ERI quote). WCWJ tower will be dismantled and WCWJ will collocate with WJXT providing significant cost-savings to the FCC. N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $371,048.00 A recent structural analysis indicates that the tower fails when changes are made that invoke EIA-222-G. The analysis states that tower cannot be upgraded to comply with the standards. Instead of building a new tower, it will be dismantled. See ERI quote. N/A N/A
Tower Helicopter Lift $738,128.00 $738,128.00 Instead of building a new tower, the WCWJ tower will be dismantled. See attached ERI quote. This cost is for the helicopter lifts required (17 days) to dismantle the tower which has a 37 percent guy radius and guy wires that cross residential streets. N/A N/A
Auxiliary Tower TOWER $775,400.00 $557,500.00 $2,000.00
Remove Interim Equipment $200,000.00 $200,000.00 Interim tower must be rigged after assigned phase is complete in order to have interim antenna, line, STL & waveguide removed from tower and disposed. Old pre-auction top-mount antenna belonging to tower owner must be reinstalled to maintain FAA height. N/A N/A
Tall Tower (greater than 500') $210,500.00 $100,000.00 Shared expense with WJXT N/A N/A
Minor tower reinforcement/modifications $158,000.00 $75,000.00 Shared cost with WJXT N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $12,500.00 Shared cost with WJXT N/A N/A
Interim Tower Lease $168,000.00 $168,000.00 See attached InSite Tower LLC quote. Costs are based on leasing space on the interim tower for 21 months at $8,000 per month. N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $2,000.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $2,000.00 N/A
Primary Tower $1,070,942.00 $711,465.00 $0.00
Tower Helicopter Lift $73,500.00 $73,500.00 See attached Erickson quote for $147,000. The WJXT tower has history of using helicopter lifts since it is a complex candelabra. Shared expense with WJXT; therefore cost is $73,500. N/A N/A
Foundation Expansion $91,642.00 $91,642.00 Quote is for $183,284. Shared expense with WJXT; therefore WCWJ cost is $91642. N/A N/A
Helicopter Site Staging Requirement $37,500.00 $37,500.00 See attached clearing quote for $75,000. Erickson Inc. requires a 200 x 200 ft clearing for lifts and the only way to achieve this is to have the area clear-cut and also requires a Strong Plank Steel Mat. Shared expense with WJXT is $37,500. N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $283,823.00 Actual costs: $477,646 for main antenna install. Since main antenna is shared with WJXT, the main antenna install cost for WCWJ is $238,823. See attached ERI quote. N/A N/A
Major tower reinforcement/modifications $421,000.00 $200,000.00 Costs for WCWJ tower mods are a shared expense with WJXT. N/A N/A

Components

Actual Information Description File Name
Helicopter Site Staging Requirement Information not provided.
Tower Mapping

Component Description:
Inv: WCWJ Tower mapping UL20180227 50% to WCWJ 50% to WJXT
Amount:
$3,687.50

Component Description:
Inv FL952GRA1422873 WCWJ Climbing Inspection UL20180510jgv1 50% to WCWJ 50% to WJXT
Amount:
$1,531.25
New tower Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Tower Helicopter Lift Information not provided.
Remove Interim Equipment Information not provided.
Tall Tower (greater than 500') Information not provided.
Minor tower reinforcement/modifications Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Interim Tower Lease Information not provided.
Structural engineering tower load study for well documented tower

Component Description:
Inv: WJXT Structural Analysis UL20180301 50% to WJXT 50% to WCWJ
Amount:
$2,000.00
Tower Helicopter Lift Information not provided.
Foundation Expansion Information not provided.
Helicopter Site Staging Requirement Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Major tower reinforcement/modifications Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $554,335.00 $523,875.00 N/A $2,257.50 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Outside Professional Services $554,335.00 $523,875.00 $2,257.50
Geotechnical Report $2,035.00 $2,035.00 Shared cost with WJXT N/A N/A
Environmental Impact Study $2,420.00 $2,420.00 Shared cost with WJXT N/A N/A
Additional Field Engineering Service, 45 Days $90,000.00 $90,000.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $10,000.00 Shared expense with WJXT N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Project management of the transition $237,000.00 $225,000.00 N/A $2,257.50 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Osborn Engineering Examination of Interim Site $51,710.00 $51,710.00 Shared cost with WJXT. See attached Osborn Engineering quote. N/A N/A
Topographic Survey $870.00 $870.00 Shared cost with WJXT N/A N/A
Intermod Study at Interim Site $500.00 $500.00 See attached InSite Tower LLC quote for required study. Shared cost with WJXT. N/A N/A
Osborn Engineering Main Transmitter Facility $8,590.00 $8,590.00 Shared cost with WJXT. N/A N/A

Components

Actual Information Description File Name
Geotechnical Report Information not provided.
Environmental Impact Study Information not provided.
Additional Field Engineering Service, 45 Days Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Project management of the transition

Component Description:
Inv: WCWJ Project Management UL20180227 50% to WCWJ 50% to WJXT
Amount:
$2,257.50
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Osborn Engineering Examination of Interim Site Information not provided.
Topographic Survey Information not provided.
Intermod Study at Interim Site Information not provided.
Osborn Engineering Main Transmitter Facility Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $192,507.88 $191,952.88 N/A $0.00 N/A
Total for all systems $9,417,733.88 $7,561,044.62 N/A $177,878.63 N/A
Other Expenses $192,507.88 $191,952.88 $0.00
STL System $43,762.88 $43,762.88 STL required at interim site. See attached STL quotes from Vernick Technology, Inc. and Data Flow Communications. Costs are $87,525.75 ($51,930.75 + $35,595 - see attached quotes). Shared cost for WCWJ and WJXT is $43,762.75. N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $10,000.00 $10,000.00 N/A N/A N/A
Equipment Storage $25,000.00 $25,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $25,000.00 $25,000.00 N/A N/A N/A
Local Zoning $25,000.00 $25,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $9,417,733.88 $7,561,044.62 $177,878.63

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Jeffrey C Gehman

Engineering Associate


05/10/2018

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  4. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

  8. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Jeffrey C Gehman

Engineering Associate


05/10/2018

Attachments

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